What is a missed abortion?

A missed abortion is a miscarriage in which your fetus didn’t form or has died, but the placenta and embryonic tissues are still in your uterus. It’s known more commonly as a missed miscarriage. It’s also sometimes called a silent miscarriage.

A missed abortion is not an elective abortion. Medical practitioners use the term “spontaneous abortion” to refer to miscarriage. A missed abortion gets its name because this type of miscarriage doesn’t cause symptoms of bleeding and cramps that occur in other types of miscarriages. This can make it difficult for you to know that the loss has occurred.

About 10 percent of known pregnancies result in miscarriage, and 80 percent of miscarriages happen in the first trimester.

It’s common to have no symptoms with a missed miscarriage. Sometimes there may be a brownish discharge. You may also notice that early pregnancy symptoms, such as nausea and breast soreness, lessen or disappear.

This is different from a typical miscarriage, which can cause:

  • vaginal bleeding
  • abdominal cramps or pain
  • discharged of fluid or tissue
  • lack of pregnancy symptoms

The causes of missed abortion are not fully known. About 50 percent of miscarriages happen because the embryo has the wrong number of chromosomes.

Sometimes, miscarriage may be caused by a uterine problem, such as scarring.

You may be at higher risk for missed miscarriage if you have an endocrine or an autoimmune disorder, or are a heavy smoker. Physical trauma can cause a missed miscarriage as well.

If you have a missed miscarriage, your doctor likely won’t be able to pinpoint a reason. In a missed miscarriage, the embryo simply stops developing and there’s usually no clear explanation. Stress, exercise, sex, and travel do not cause miscarriage, so it’s important not to blame yourself.

You should always see a doctor if you suspect any kind of miscarriage. Call your doctor if you have any miscarriage symptoms, including:

  • vaginal bleeding
  • abdominal cramps or pain
  • discharge of fluid or tissue

With a missed miscarriage, a lack of pregnancy symptoms may be the only sign. For example, if you were feeling very nauseated or fatigued and you suddenly don’t, call the doctor. For most women, you likely won’t be aware of a missed miscarriage until your doctor detects it during an ultrasound.

A missed miscarriage is most often diagnosed by ultrasound before 20 weeks’ gestation. Usually, the doctor diagnoses it when they cannot detect a heartbeat at a prenatal checkup.

Sometimes, it’s simply too early in the pregnancy to see a heartbeat. If you’re less than 10 weeks pregnant, your doctor may monitor the level of the pregnancy hormone hCG in your blood over a couple days. If the hCG level doesn’t rise at a typical rate, it’s a sign the pregnancy has ended. They may also order a follow-up ultrasound a week later to see if they can detect the heartbeat then.

There are several different ways to treat a missed miscarriage. You may be able to choose or your doctor may recommend a treatment they feel is best for you.

Expectant management

This is a wait-and-see approach. Usually if a missed miscarriage is left untreated, the embryonic tissue will pass and you’ll miscarry naturally. This is successful in more than 65 percent of women experiencing missed miscarriage. If it’s not successful, you may need medication or surgery to pass the embryonic tissue and placenta.

Medical management

You may choose to take medication called misoprostol. This medication helps trigger your body to pass the remaining tissue to complete the miscarriage.

You’ll take the medication at the doctor’s office or hospital, and then return home to complete the miscarriage.

Surgical management

Dilation and curettage (D&C) surgery may be necessary to remove remaining tissue from the uterus. Your doctor may recommend a D&C immediately following your diagnosis of a missed miscarriage, or they may recommend it later if the tissue doesn’t pass on its own or with the use of medication.

Physical recovery time after miscarriage can vary from a few weeks to a month, sometimes longer. Your period will mostly likely return in four to six weeks.

Emotional recovery can take longer. Grief can be expressed in a variety of ways. Some people choose to perform religious or cultural memorial traditions, for example. Talking with a counselor may help as well.

Talking with other people who’ve experienced pregnancy loss is important. You can find a support group near you through Share Pregnancy & Infant Loss Support at NationalShare.org.

If your partner, friend, or family member had a miscarriage, understand that they may be going through a tough time. Give them time and space, if they say they need it, but always be there for them as they grieve.

Try to listen. Understand that being around babies and other pregnant women might be difficult for them. Everyone grieves differently and at their own pace.

Having one missed miscarriage doesn’t increase your odds of having a future miscarriage. If this is your first miscarriage, the rate of having a second miscarriage is 14 percent, which is about the same as the overall miscarriage rate. Having multiple miscarriages in a row increases your risk for a subsequent miscarriage, however.

If you’ve had two miscarriages in a row, your doctor might order follow-up testing to see if there is an underlying cause. Some conditions that cause repeated miscarriage can be treated.

In many cases, you may be able to try to get pregnant again after you’ve had a normal period. Some doctors recommend waiting at least three months after the miscarriage before trying to conceive again.

One recent study suggests trying again before three months may give you the same or even increased odds of having a full-term pregnancy, however. If you’re ready to try to become pregnant again, ask your doctor how long you should wait.

In addition to being physically ready to carry another pregnancy, you’ll also want to make sure that you feel mentally and emotionally ready to try again. Take more time if you feel you need it.